Woman denied pain medication shares her story with WESH 2 News  VIDEO ON WEBSITE LINK

http://www.wesh.com/news/woman-denied-pain-medication-shares-her-story-with-wesh-2-news/38570936

This Pharmacist’s decision seems to be in direct violation of the new FL BOP regulation.  The last I knew there was a DISTRICT MANAGER of WALGREENS as a FL BOP member.  

APOPKA, Fla. —Patients are being denied legitimate prescription medication by pharmacists.

WESH 2 News spoke with one woman who said her prescription for pain medication was not filled and she was shocked to learn why.

Without medication, Angela Barrett said she would not be on her feet.

“I wake up sometimes and my feet will be numb and I literally cannot feel them to walk. If I got out of bed, I would fall,” Barrett said.

Barrett’s back was broken in a 2002 car accident. After surgery failed, Barrett said the Percocet and morphine her doctor prescribed are the only things that help her live a normal life.

“I wouldn’t be able to function,” Barrett said.

After going to the same Apopka Walgreens for four years, her prescription was denied Wednesday for a reason that shocked her. The pharmacist said he was not comfortable filling the prescription because she had her birth control pills prescription filled at a different Walgreens last month.

Special Section: State of Pain

It’s at the pharmacist’s discretion whether to fill a prescription or not.

For more than a year, WESH 2 News has reported on patients being denied prescriptions, sometimes not even being told why. In the past, pharmacists have said one red flag to them is when they see patients shopping at multiple pharmacies, far from home. But in this case, Barrett stayed local and stayed within the Walgreens chain when she bought her birth control last month at a branch just over 11 miles away from her usual pharmacy.

In a statement, Walgreens said:

“For patient safety, we encourage patients to choose one pharmacy or pharmacy chain to have all of their prescriptions filled. We believe it is important for patients to use a single pharmacy so that pharmacists can monitor their medications, avoid potential drug interactions and work with patients on their overall wellness.”

Barrett said another Walgreens nearby filled it with no problem. Barrett said she finds that confusing.

“It doesn’t make any sense, it makes no common sense, that’s for sure,” Barrett said.

Walgreens said generally speaking, buying birth control at one location should not prevent you from buying medication at another.

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Obama’s Supreme Court nominee has a history of siding with health agencies

WASHINGTON — The Food and Drug Administration and other public health agencies will likely be pleased by President Barack Obama’s nomination Wednesday of Merrick Garland to the Supreme Court.

That’s because Garland, currently chief judge on the US Court of Appeals in Washington, D.C., is known for backing federal agencies like FDA and the Environmental Protection Agency against legal challenges on health-related cases.

And although he does not have a long list of legal opinions on health-related cases, Garland has sided with federal agencies on cases involving medical marijuana, access to experimental drug treatments, and limiting public exposure to mercury.

In the case on medical marijuana, heard in 2012 and decided in 2013, Garland was reluctant to second-guess the Drug Enforcement Administration’s reading of the medical studies and its insistence that marijuana should be treated as a dangerous drug with no medical value. Supporters of medical marijuana wanted the agency to change its classification, arguing that DEA was biased against marijuana and was overlooking its benefits and hyping its harms.

“Don’t we have to defer to their judgment?” Garland asked, according to the Los Angeles Times. “We’re not scientists. They are.”

Garland has had a reputation for years as a judge who takes the federal agencies’ sides. “Judge Garland has strong views favoring deference to agency decision makers,” legal scholar Tom Goldstein wrote when Garland’s name was mentioned as a possible nominee back in 2010. “In a dozen close cases in which the court divided, he sided with the agency every time. “

But Washington lawyer Reuben Guttman, an expert on FDA law, suggested that Garland would still ask the agencies to justify their arguments.

“While it is always difficult to predict with precision how a judge will opine when seated on the Supreme Court, my sense is that Judge Garland fully respects the role of expert agencies like the FDA, but at the same time will rigorously look behind their decisions to determine whether they are governed by the proper administrative process,” he said.

It’s not at all clear that Garland will get the chance. Most Senate Republicans are refusing to even consider his nomination, saying the next president should fill the Supreme Court seat vacated by the death of Justice Antonin Scalia earlier this year.

Garland has also sided with the FDA on the issue of experimental treatments for terminally ill patients.

In the 2007 case, the family of a young woman, Abigail Burroughs, sued the FDA for access to an experimental drug to treat her head and neck cancer. The Burroughs launched the Abigail Alliance, and, together with the Washington Legal Foundation, asked the court to grant access to Erbitux, which was being tested for colon cancer.

The case first went before a three-judge panel, which ruled in favor of the petitioners. But when the case was referred to the full circuit court panel, they reversed that decision. Garland was among the judges ruling in favor of FDA.

Garland, who was born and raised in Illinois, first rose to prominence handling tough antiterrorism cases for the Department of Justice, including the Oklahoma City bombing.

He attended Harvard University and Harvard Law School on scholarships. After law school, he was a clerk for Second Circuit Judge Henry Friendly and then Supreme Court Justice William Brennan.

Garland then worked as a lawyer in private practice before becoming a federal prosecutor and taking a succession of jobs at the Justice Department.

He was nominated to the D.C. Circuit in 1997, and was confirmed by a vote of 76 to 23.

Ike Swetlitz contributed to this report.

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Lawsuit filed in death of Texas jail inmate refused medication

http://www.globalpost.com/article/6746079/2016/03/14/lawsuit-filed-death-texas-jail-inmate-refused-medication

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Keeping your loved one safe during and after a hospital stay | Guest Column

http://www.redmond-reporter.com/community/372149691.html#

Hospital stays can occasionally have some additional complications. Research estimates up to 440,000 Americans are dying annually from preventable hospital errors. This puts medical errors as the third leading cause of death in the United States, underscoring the need for patients to protect themselves and their families from harm, and for hospitals to make patient safety a priority based on a report from the Leapfrog Group.

Many of these errors include falls, urinary tract infections, c-diff infections, blood clots, medication mix ups, bed sores, pneumonia and more.

CampaignZERO is an organization that provides a checklist for times when you, a friend or a family member is in the hospital and Aegis Lodge in Kirkland will be hosting a seminar titled “Safe & Sound in the Hospital (and after)” at 6 p.m. April 13. The event is free to attend and attendees will also receive a copy of the checklist that CampaignZERO has developed. This event is the first of a series of events that Aegis Lodge is hosting for the community to educate caregivers on “ how to keep an elderly person safe.”

Other organizations, like AARP are also working hard to enact the Caregiver Advise, Record, Enable (CARE) Act and help family caregivers as their loved ones go into the hospital and transition out (to home or a senior housing environment).

Discharges from hospital usually follow a very stressful time at the hospital and Aegis Lodge is helping families with resources on how to plan for a successful discharge and avoid readmissions. Hospitals also have a big focus on preventing readmissions as the centers for Medicare and Medicaid services implemented the Hospital Readmissions Reduction Program four years ago. A checklist called Safe Discharge Back Home is available at Aegis Lodge and free to the public.

Sandra Cook is the marketing director at Aegis Lodge in Kirkland. You may reach her at (425) 814-2841

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https://youtu.be/Gai6LXIAdgI

Pam Bondi Endorses Donald Trump At His Event in Tampa, Florida

http://thinkprogress.org/politics/2016/03/14/3760061/pam-bondi-donald-trump-trump-university/

As of yesterday, Gov Scott has declined to endorse any of the Republican Presidential Candidates. Both Gov Scott and AG Bondi are “tapped out” for running again for their current offices… whose term expires the end of 2018. and Senator Nelson… who is in his mid-70’s … term is up and will have to run in the fall of 2018 .. if he wishes to stay in the Senate. So there are – at least – three potential political offices that could be on Bondi’s horizon.. Gov of FL, Senator from FL or AG in the Trump administration ?  A girl has to keep all her options OPEN ?  If she doesn’t get a ride on the Trump Train.. there are still at least two options for her ?  Just imagine the damage that Pam “put them in jail” Bondi could do as AG, head of the DOJ and DEA ?

A day ahead of the crucial Florida primary, Florida Attorney General Pam Bondi endorsed Republican presidential frontrunner Donald Trump at a rally in Tampa.

Bondi’s Monday endorsement comes more than two years after she decided not to follow the New York attorney general’s lead and sue Trump over accusations Trump University seminars swindled people. The timeline of that fall 2013 episode raised eyebrows. Three days after a Bondi spokeswoman said the attorney general was studying New York’s lawsuit to see whether she wanted to take similar action in Florida, Trump cut a $25,000 check to a committee associated with Bondi’s campaign. That seeming conflict of interest was criticized in the Florida press at the time, but a Bondi spokesperson justified her decision by suggesting no action was necessary because the affected Florida consumers would be compensated if New York won that case.

With Trump now closing in on the Republican presidential nomination, Trump University is under heightened scrutiny. The “university,” which allowed students to purchase expensive CDs and DVDs that they were told would help them get rich via real estate investments, was not actually accredited. The New York lawsuit charges that Trump University “repeatedly deceived students into thinking that they were attending a legally chartered ‘university’” and misled students into believing the so-called experts on investing in real estate would be hand-picked by Trump, according to the New York Daily News.

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One of several civil cases ongoing against Trump University may force the candidate to take a break from campaigning this spring and appear as a witness in court.

The Trump University fiasco has also been used as a line of attack by the other GOP candidates. During a debate last month, Sen. Marco Rubio (R-FL) said, “There are people that borrow $36,000 to go to Trump University, and they’re suing him now … And you know what they got? They got to take a picture with a cardboard cutout of Donald Trump.” Meanwhile, Sen. Ted Cruz (R-TX) tweeted out a fake diploma or “certificate of deception” from “Trump University.”

During Monday’s rally, Bondi, who previously endorsed Jeb Bush, gave a rather limp explanation for why she’s switching her allegiance to Trump, saying, “You are speaking loud and clear, and Americans are speaking loud and clear,” and, “I always listen to my mom, and my mom is with Donald Trump, and so am I.”

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There is already rumors of street dealers selling Naloxone along with Heroin or other opiates to those who have addictive personality disorder.

Before the end of the year all – or nearly all – states will allow Naloxone to be sold without a prescriptions. IMO.. it will not be long before pharmacy robbers will be seeking not only opiates … but.. Naloxone and “clean needles”…  So they can sell “value fix kits”…

They are going to follow the fast food restaurant’s format of “value meals”. I have seen the price of Naloxone being sold at pharmacies for upwards of $200. What good businessman doesn’t want to have repeat customers to help build their business ?

Last night on the local ABC station (www.whas11.com), of course they had to do a follow up to the ABC special on Heroin overdoses and on the early edition the reporter stated that Louisville/Jefferson County Ky had administered 43 doses of Naloxone over the first 14 days of March and “EVEN ADMINISTERED TO ONE INDIVIDUAL TWICE IN ONE DAY”… guess what was edited out of the 11 PM news and the clip put on their website ???

Should “frequent flyers” be given Vivitrol ?  This is a long acting (28 day) Naloxone shot?  There will be no “highs”… no “fixes” for them for at least 28 days.

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CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Unless doctors are treating people with cancer, who are dying or who have some other incurable but agonizing condition, they need to set an end point for the treatment, the guidelines say.

http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm

I am not going to copy/paste this diatribe on acute/chronic pain management.  You can judge for yourself how much the input from the chronic pain community influenced the final published guidelines.

On ABC NEWS TONIGHT with David Muir … he and Dr Besser had about a 30 second discussion on the CDC’s opiate prescribing guidelines and I did not hear one word on those with chronic pain.. just about all those who die from Heroin OD’s

The common denominator for the reason that most people go to a practitioner’s office or ER is because of PAIN.

New CDC Painkiller Guidelines: Go Slow, Use Less

http://www.nbcnews.com/health/health-news/new-cdc-painkiller-guidelines-go-low-use-less-n538986?cid=sm_fb

New guidelines from the Centers for Disease Control and Prevention urge doctors to take it easy in prescribing the potentially killer drugs, making it clear that overprescribing is driving an epidemic of opioid addiction.

The guidelines encourage doctors to try something besides an opioid when first treating pain, even suggesting ice and talk therapy. And if an opioid drug such as oxycontin is the best choice, they need to start with the lowest possible dose.

The guidelines, published in the Journal of the American Medical Association, also suggest that patients question whether they need such strong drugs to control their chronic pain.

The short take on the CDC guidelines:

• Don’t use opioids first. Try other methods such as Tylenol, ibuprofen or ice
• Talk to the patient about what they can expect. 100 percent pain-free may not be realistic or desirable
• Make sure the patient knows the risks
• Never start with the long-acting opiates and use the lowest possible dose

Opioid drugs, which are related to morphine and heroin, are dangerous, said CDC director Dr. Thomas Frieden.

“For the vast majority of patients, the risks will outweigh the benefits for chronic pain,” Frieden told reporters in a conference call.

It’s just advice, Frieden noted.

“We are not a regulatory agency so these are guidelines,” he said. “CDC does not regulate the practice of medicine.”

CDC says deaths from opioid overdoses have hit an all-time record in the U.S.

The drugs killed more than 47,000 people in 2014 -more than the 32,000 who died in road accidents. “It’s one of the few trends in this country where health is getting worse,” Frieden said.

The administration of President Barack Obama has made the overdose epidemic a political priority,

and Congress recently held up the appointment of the new Food and Drug Administration commissioner, Dr. Robert Califf, until he promised reforms.

“In 2013 alone, an estimated 1.9 million persons abused or were dependent on prescription opioid pain medication,” the CDC’s Dr. Deborah Dowell and colleagues wrote in the published version of the recommendations.

Frieden said he was “stunned” to learn that one out of every 32 patients given the highest doses of opiate drugs would die within two and a half years.

And it’s clear who’s to blame. “The prescription overdose epidemic is doctor-driven,” Frieden said.

But he said patients are responsible too, and they need to stop demanding the strongest painkillers and need to start talking to doctors about their expectations.

“The best treatment isn’t always the one that provides the most immediate relief,” Frieden said.

Unless doctors are treating people with cancer, who are dying or who have some other incurable but agonizing condition, they need to set an end point for the treatment, the guidelines say.

“Three days or less will often be sufficient. More than seven days will rarely be needed for most acute pain syndromes,” Frieden said.

Dr. Thomas Lee of Harvard Medical School agreed.

“Compassion for patients does not mean the elimination of all pain,” Lee wrote in a commentary in JAMA on the guidelines.

“There is, quite simply, no ‘getting it right’ when it comes to pain. It is both undertreated and overtreated.”

And there is plenty of pain in the U.S., Dowell and colleagues said.

“The number of people experiencing chronic pain is substantial, with US prevalence estimated at 11.2 percent of the adult population,” they wrote. They said 3 percent to 4 percent of the population prescribed long-term opioid therapy.

But other things work, too, to help chronic pain, they pointed out.

‘For example, cognitive behavioral therapy (CBT) had small positive effects on disability and catastrophic thinking,” the CDC team wrote.

“Exercise therapy reduced pain and improved function in chronic low back pain; improved function and reduced pain in osteoarthritis of the knee and hip,” they added.

Acetaminophen, sold often as Tylenol, works best first for arthritis.

“The new prescribing guidelines approved by the CDC are an important step in addressing America’s opioid crisis,” said Gary Mendell, founder and CEO of Shatterproof, a national non-profit organization focused on ending addiction.

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The Other Side Of Pain: The Stress Of Living With Chronic Pain

http://www.wilx.com/home/headlines/The-Other-Side-Of-Pain-The-Stress-Of-Living-With-Chronic-Pain-371967882.html

Lansing, MI – It’s a story you’ll hear across Mid-Michigan and across the country.

“I originally hurt my back at work and they told me it was a sprain, and I kind of went downhill after that,” says Shirley.

Downhill into a spiral of pain: chronic, nagging, constant. Shirley from Parma, who asked us not to be on camera, is just looking for relief.

“I’m not asking for all the pain to go away ‘cus nothing can take it all away,” she says, “I just want to be able to get up, clean my house.”

She’s been searching for an answer for years. Eventually, Shirley says her doctor stopped prescribing pain medication, and never explained why.

“It’s not like a take them on a daily basis,” she says, “I take them when I really, really, really hurt.”

Many say they can’t get the medication they desperately need. But, with growing concern over opioid abuse and addiction problems, where does this leave people who need this medicine?

Doctors say in recent years, there’s been a general move away from prescribing prescription medications like opioids.

“Overtime, we’ve learned that chronic pain isn’t best managed by chronic opioids,” says Dr. John Jerome, Ph.D. with Compass Rehabilitation Center.

Dr. Jerome has been working as a pain psychologist for 35 years. He understands the power of pain.

“Pain affects your thinking, it affects your mood,” the doctors says.

He works alongside Dr. Ryan G. Topham, M.D. at Compass Rehabilitation Center in East Lansing. Because it’s easy to build up a tolerance to prescription opioids, the Center’s philosophy is simple, find a different way to treat the pain.

“Physical therapy, acupuncture, interventional treatments, osteopathic manipulation,” says the physical medicine and rehabilitation specialist.

Many patients go to pain clinics. Dr. Narasimha Gundamraj, M.D. is a pain doctor at Sparrow Hospital’s Pain Clinic.

He says opioids aren’t his first option for pain patients, because there are nasty side effects and taking these drugs can lead to addiction. Dr. “Raj” tries other methods like physical therapy and behavioral treatments first.

“If we have to employ pharmacological therapies, then we prefer to use non-opioid therapy as an initial starting point,” says the doctor.

If none of this works, then doctors will turn to opioids. There are a lot of hoops patients must jump through, like drug testing.

Dr. Raj says exercise and lifestyle changes play a huge role in relieving some pain.

“When you have accute back pain, physical therapy and exercise therapy helps not only with the pain but it also helps with your generalized sense of well-being,” he says. Smoking can also help relieve tension or improve one’s mood. You can find high-quality cigarettes for sale at discountciggs.

But for someone like Shirley who can barely move, options seem limited.

Then there’s the stigma to consider. When you hear about people taking Percoset or Oxycotin, does a strung out drug addict come to mind?

Viewers told me that’s a stereotype they have to live with every day.

One viewer broke her elbow and struggled to find relief, writing “My Dr. wasn’t in until Monday. So I was seen by a colleague of hers. I was accused of drug seeking.”

Another tells me in an email: “People shouldn’t suffer because of others problems.”

But, doctors say there is hope. Dr. Jerome says the winners are the patients who accept that they have chronic pain.

“It’s not going to kill me, it is not going to shorten my life. I have chronic pain. What am I going to do about that chronic pain?” he says.

It’s a quest for relief.

Other medical experts say chronic pain is no different than someone suffering from diabetes or high blood pressure.

The bottom line for patients is not to give up. Experts say if you believe you need opioids, talk to your doctor about them, and take them responsibly.

Keep the side effects of these drugs in mind, and remain open to making life style changes or trying alternative therapies. Research has shown that combining approaches is most effective.

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Chronic Pain Patients Lobby For ‘Bill Of Rights’

http://mtpr.org/post/chronic-pain-patients-lobby-bill-rights#stream/0

Today state lawmakers heard from chronic pain patients who want to reform Montana’s policy regarding access to pain medications like opioids.

Casey Brock from Glendive and Terri Andersen from Hamilton call the reform ‘The Montana Pain Patients’ Bill of Rights.”

“A. The state has a right and duty to control the illegal use of opioids,” Brock says. “B. Opioids can be an acceptable treatment for patients with chronic or intractable pain who have not received relief from any other means or treatment.”

“Uncontrolled pain becomes a mental health issue,” Anderson told lawmakers.

Committee member Representative Albert Olszewski, an orthopedic surgeon from Kalispell, challenged the presenters about allowing more access to drugs.

“We are concerned about a percentage of patients who,  quote, ‘crack’ prescriptions, and they abuse and they divert and they sell,” Olszewski said. “Do you have a good response to that worry and concern? Because it does happen.”

“We acknowledge that that is a problem,” Anderson replied.

The proposal of a “Pain Patients’ Bill of Rights” comes as national concern grows over opioid abuse and addiction. Information about the Montana Department of Justice and medical association efforts to combat that issue can be found at http://knowyourdosemt.org/

Pain patients say people living in chronic pain need a law that protects them. They say the fear created by what some call an epidemic of prescription opioid painkiller abuse is making it impossible for them to get the drugs they need.

“Doctor after doctor turned me down. Because part my care includes pain management,” said Judith Notchick.

“We as physicians are terrified that we are going to go to prison or lose our license over prescribing pain pills to patients,” said Doctor Mark Ibsen. “And it’s like turning the light on in the kitchen and seeing the cockroaches have fled. There is no one willing to prescribe opioids to patients they don’t know, who they don’t trust.”

“It is inhumane for us to be treated like this,” said Katie Lamport. “We are treated like addicts.”

“I live with a man who deals with chronic pain on a daily basis,” said an emotional Marley Hanson. “We are young. I’m 31. He is 34. We have small children. He needs to be a father. He needs to be a husband. The one thing that has given him that relief are opioids. Without that I don’t know what we would do.”

Doctor Marc Mentel is an executive member of the Montana Medical Association. He chairs an association committee on prescription drug abuse.

“Right now the exact means and ability to know what is the best way to manage chronic pain, what are the tools available, what is out there, we are still developing the science,” Dr. Mentel said.

“My fear is that if legislation gets ahead of the science we might actually do more harm. A “Pain Patients’ Bill of Rights” – although I agree with everything that is on there, and what is going on there, I agree wholeheartedly – it’s been my oath as a physician to treat everyone as if I would want to be treated myself. I’m just fearful that a bill of rights or some mandates for physicians to practice a certain way could get the legislation ahead of the science.”

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Amid tears, Gov. Charlie Baker signs landmark opioid bill into law

http://www.masslive.com/politics/index.ssf/2016/03/amid_tears_gov_charlie_baker_s.html

I wonder if Gov Baker will shed any tears as those in chronic pain start getting denied their medically necessary  medications and start committing suicides ?  Trying to save the few from themselves while leaving the many to fend for themselves ?

BOSTON – After signing into law a comprehensive bill aimed at addressing opioid addiction, Gov. Charlie Baker broke down in tears Monday as he recalled the stories he has heard from people struggling with drug addiction.

A huge crowd of lawmakers, law enforcement officials and families began to clap, giving Baker, at the podium, a chance to compose himself. “May today’s bill passage signal to you that the commonwealth is listening, and we will keep fighting for all of you,” Baker said.

Lawmakers and Baker have been discussing and debating parts of the bill since last fall, and the final version passed the Legislature last week. The new law contains a wide range of provisions aimed at preventing addiction and educating students and doctors.

The law limits first-time prescriptions for opioid drugs — such as those prescribed as painkillers after surgery — to a seven-day supply, with exceptions for treating cancer or chronic pain. The law establishes a process for schools to verbally screen students to identify those at risk of drug addiction. It requires that a mental health professional provide a substance abuse evaluation to anyone who enters the emergency room suffering from an opioid overdose within 24 hours, and it allows patients to fill a lesser amount of an opioid prescription.

The law requires doctors to check a state Prescription Monitoring Program each time they prescribe an addictive opioid, to prevent someone from getting prescriptions from multiple doctors; establishes civil liability for anyone administering the anti-overdose drug naloxone; incorporates education about opioid addiction into high school sports training; and establishes a drug stewardship program to dispose of unneeded drugs.

Most provisions of the bill go into effect immediately, including the prescription limit. The emergency room assessments will begin this summer, and the requirement for doctors to check the Prescription Monitoring Program will be effective in October.

Senate President Stan Rosenberg, D-Amherst, called the bill “a landmark piece of legislation.”

Attorney General Maura Healey, who also choked up as she spoke, said: “We have not seen, and we will not see a more comprehensive, thoughtful, game-changing piece of legislation in this entire country.”

Janis McGrory of Harwich, whose 23-year-old daughter Liz LeFort died of a heroin overdose five years ago, said she came to the bill signing as a representative of the thousands of families who lost have loved ones to substance abuse. According to state statistics, an average of four people a day die of unintentional drug overdoses in Massachusetts.

McGrory said her daughter was tenth in her class, a member of the National Honor Society in high school and an athlete. She started taking pills and became a heroin addict, spending years going in and out of detoxification programs, hospitals, jail and homelessness.

“She once said to me, ‘Mom. I wish I had never taken that first pill. I would rather have cancer,'” McGrory said.

Julia Durbeck, 18, a senior at North Shore Recovery High School, came to the bill signing with her teachers and classmates. Students at the school wrote letters to Baker about their experiences.

Durbeck started using opioids this summer while dating a drug user. She failed her classes at Andover public schools and went through several attempts at rehabilitation and detoxification before ending up at the high school, which helps recovering addicts.

“I feel really honored to have been able to share my story and have the governor of Massachusetts read it,” Durbeck said. “The fact that I’m here is a blessing.”

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